Certainly, symptoms can be worse if there are other things going on. That's why it's important to be evaluated, because there can be more going on. Patients will come and complain with symptoms of menopause and with evaluation there can be more than just menopause going on. There can be sleep apnea. There can be other issues that are exacerbating the way the patient feels.
As far as lifestyle changes, obviously weight gain, not getting adequate exercise, not getting adequate sleep are going to exacerbate the symptoms of menopause along with just the patient's general feeling of wellbeing.